Not All Fish Are Equal: How to Choose for a Healthier Heart

Eating fish regularly can boost heart health, but not all types offer the same benefits. Some varieties are rich in omega-3 fatty acids, which help lower cholesterol and blood pressure, while others may contain high levels of mercury or unhealthy fats. Health experts recommend choosing fish wisely to maximise advantages and avoid risks. Fatty fish, such as salmon, mackerel, herring, trout, anchovies, and sardines, are among the best choices for heart health. Their high omega-3 content helps regulate cholesterol, triglycerides, and inflammation, reducing the risk of cardiovascular disease. A 2022 study even found that these benefits are unique to fatty fish and not found in other types.

Tuna, though not classified as a fatty fish, still provides heart-healthy omega-3s—more than other tuna varieties. However, bigeye tuna, along with tilefish, swordfish, shark, and king mackerel, should be eaten in moderation or avoided due to high mercury levels. Lean fish like cod, sole, and haddock are low in fat and calories but high in protein, making them another good option. Yet some, such as tilapia and catfish, have an unbalanced omega-6 to omega-3 ratio, which could harm heart health if eaten too often. Shellfish, including oysters and shrimp, contain omega-3s but may also be high in cholesterol, posing a concern for those with certain conditions. The American Heart Association advises at least two servings of fish per week. Pregnant or nursing women, however, should limit intake to two or three servings, focusing on low-mercury options.

Health guidelines encourage regular fish consumption for its heart-protective effects, particularly from fatty varieties. But careful selection is key—avoiding high-mercury species and balancing omega-3-rich choices with leaner options. Following these recommendations can help maintain cardiovascular health while minimising potential risks.